Positional plagiocephaly and neurodevelopment: a narrative review

Abstract

Positional plagiocephaly is a common pediatric pathology that has been considered as a cosmetic condition, but recently its association with neurodevelopmental delay has been explored.

Objective: To perform a narrative review updating the findings of a 2017 systematic review on plagiocephaly and neurodevelopment.

Methodology: Articles in the MEDLINE, PubMed, Google Scholar, and DeepDyve databases were reviewed, data were extracted from the most relevant studies evaluating their methodological quality. The search terms used were: “plagiocephaly”, “positional plagiocephaly”, “brachycephaly”, “motor skills”, “development”, “developmental delay”, “neurodevelopment”, “language acquisition”, “psychomotor performance”, and “cognition”.

Results: The search found 198 articles, of which 14 met the inclusion criteria. A child population aged 4 to 11 months to 8 years was observed. The study highlighted limitations including potential selection bias, use of the same population in several studies, and lack of diagnostic consistency. The results showed a positive association between plagiocephaly and neurodevelopmental delay. The studies of higher methodological quality identified delays in different developmental stages (7, 18, and 36 months, and school-age) and dimensions (motor skills, cognition, behavior, and language).

Conclusion: There is an association between plagiocephaly and neurodevelopmental delay. Primary care professionals should monitor infants with this condition in order to initiate proactive interventions.